[Extracorporeal treatment of hemolytic complications in multifield surgical clinic].

AIM: to optimize the protocol of high-volume plasmapheresis for hemolytic complications in surgical practice.

MATERIAL AND METHODS: We studied 100 patients aged 7-73 years with hemolytic complications. In 83 patients with free hemoglobin level over 200 mg% 50-300% of plasma volume was removed. In 32 patients (15 of them with plasmapheresis and 17 without it) renal function was assessed comparatively. Plasmapheresis was used in case of significantly higher values of hemolysis (p<0.01).

RESULTS: Cardiac patients make 95% of observations. They had intraoperative hemolysis due to plonged extracorporeal circulation (93) and injection of 16-18-day blood preserved with glugjcirum into pump oxygenator (2). Hemolytic complications were observed in 5 patients. Autoerythrocytes disintegration occurred in 95 cases. Efficacy of plasmapheresis to eliminate free hemoglobin was 95%. Severity of acute renal injury depended on hymolysis intensity. Renal function recovery was diagnosed in 2-3 days postoperatively. Plasmapheresis facilitated microalbuminuria and concentration function restoration.